Comparing Visual Performance and Subjective Outcomes with an Enhanced Monofocal Intraocular Lens When Targeted for Emmetropia or Monovision.

Purpose: To evaluate relative visual performance and subjective outcomes after implantation of the TECNIS Eyhance™ intraocular lens (IOL) targeted for bilateral emmetropia or monovision.

Methods: This was a prospective, single-center randomized, patient-masked trial. Patients were implanted with the enhanced IOL targeted for bilateral emmetropia or slight monovision (-0.75 D in the non-dominant eye). At 3 months the binocular visual acuity (VA) was measured at distance, intermediate and near, along with low contrast VA in photopic and mesopic conditions, and the distance corrected defocus curve. Questionnaires related to spectacle independence, satisfaction, visual symptoms, and functional vision were administered.

Results: Data from 71 subjects (34 Emmetropia, 37 Monovision) were analyzed. There was no difference in the mean uncorrected distance VA (p = 0.11), but uncorrected intermediate and near VAs were one line better in the Monovision group (p = 0.02 and 0.01, respectively). Mesopic and photopic low contrast VA were similar between groups. There was a trend for less difficulty and higher satisfaction with near and intermediate vision in the Monovision group, but no significant differences in any of the subjective questionnaires. Difficulty reading was the most reported concern in both groups, though 93% of all subjects reported "little" or "no" difficulty with daily activities. Overall, 82% of subjects were "completely" or "very" happy with their lens choice.

Conclusion: Using this enhanced IOL with slight monovision in the non-dominant eye increased intermediate and near VA with no apparent effect on low contrast distance VA, subjective visual quality, or satisfaction.